Psychedelics and Entactogens in Psychotherapy

Before
the sixties when "abuse" of psychedelics had become widespread, substances like
LSD and psilocybin were the subjects of much scientific research. Lysergic acid
diethylamide, among others, appeared to hold infinite possibilities for
exploration of the mind on many levels. It was investigated by the government
for its use as a "truth-serum." It also attracted the interest of
psychiatrists. Since then, there have been numerous studies showing that
psychedelics and entactogens are useful tools in the treatment of some
psychological disorders.

For the
scope of this paper, the term psychedelic will be used to describe any
substance that is capable of creating an experience involving "ego dissolution."
Psychedelics allow a person to see and judge himself as another person
would see him. Chemicals that fit into this category include LSD, psilocybin,
mescaline, ketamine, and MDA among others. The term psychedelic is not
synonymous with hallucinogen. An entactogen is a substance that incites a sense
of "connectedness" with one's surroundings. It is used interchangeably with the
term empathogen. The term literally means, "to touch within." Entactogens ease
the process of opening up and sharing one's emotions or troubling memories. The
most notable member of this category is MDMA. It is possible for a substance
to be both psychedelic and entactogenic.

Lysergic
acid diethylamide was appealing to psychotherapists because of the range of
effects it had on people: causing panic, fear, confusion, delusions, ego
dissolution, or euphoria. It had the ability to separate a person from his own
self, allowing him to analyze his life and his character without bias. This
experience had the potential to catalyze a change in his value system,
ultimately affecting his behavior. Studies were conducted with many different
types of patients: schizophrenics, obsessive-compulsive, alcoholic,
post-traumatic, depression, etc. The drug was used with varying success in many
of these, however much of the data is inconclusive.

Originally published in
1959, The Handbook for the Therapeutic Use of Lysergic Acid Diethylamide-25
, provided a model for
effective use of LSD-25 in psychotherapy sessions. The book goes into great
detail on how to conduct an effective therapy session, focusing on sessions
involving high doses of LSD-25. Higher doses, the authors stated, bring about
the maximum value of the experience, permitting an increased self-understanding
and a reassessment of values. Of the two hundred or so sessions observed, 35%
of the patients exhibited a permanent relief of symptoms following a single
session (Blewett and Chwelos 73). A study using this method to treat alcoholism
was conducted on 24 patients with generally severe prognosis. Twenty of which
failed to remain dry after trying AA. Following treatment, around half showed
improvement, and six of the patients never drank again (71).

In the Netherlands, the
most well known psychiatrist to work with psychedelic drugs was Jan Bastiaans.
He had developed a treatment method for victims of "KZ Syndrome," or
Concentration Camp Syndrome, which was known as "Bastiaans' method." Bastiaans'
method used psychedelics as a last resort to allow his clients to re-experience
the traumatic event and bring about integration and recovery from the
psychosis. LSD-25 was used primarily, and occasionally psilocybin or ketamine.
LSD produces "emotionally laden hallucinations, affects ego functioning, and
facilitates the recollection of past events and associated emotions" (Maalte
and Ossebard). Based on the preliminary follow-up study, it is difficult to
assess the overall effectiveness of Bastiaans' method. Ex-participants were
difficult to contact, and it was impossible to tell how many clients were
treated with psychedelics and of those, how many were partially or fully
relieved of their symptoms. Nonetheless, of the small number of ex-participants
that were contacted and interviewed, many reported that they had been cured or
palliated. One ex-participant claimed, "I learned a lot about earlier
experiences which I didn't know were stored in my head" (Maalte and Ossebard).

During the 1970s, when
LSD, psilocybin, and other common psychedelics were banned in much of the
world, scientific studies with these substances came to a near halt. The
practice of psychedelic psychotherapy had moved underground. Sessions are
conducted, for the most part, in groups, and are not advertised (Philipkoski).
It is impossible to provide conclusive statistical information about the effectiveness
of these sessions; however, numerous first-hand and second-hand accounts are
available, many showing very positive results.

In 1997, a book was published documenting
the practices of an underground psychotherapist known as "Jacob." It was called
The Secret Chief,
after the nickname given to Jacob by Terrence McKenna. Jacob utilized a variety
of substances (both psychedelics and entactogens), including LSD, ibogaine,
TMA, mescaline, MDMA, MDA, and harmaline (also called yagé). Each experience
had its own unique flavor. First-time patients had a one on one session with
Jacob using LSD-25. The purpose of the individual session is to familiarize the
patient with the psychedelic experience and to assess their ability to handle
such an experience. The group sessions allow people to "try new things, and to
connect with a lot of individuals" (Stolaroff). These sessions usually
consisted of ten to twelve participants and took place on Friday evenings.
Jacob reported good results with his patients.

One example documented
in The Secret Chief, is the case of a 34 year old graphic artist named
Susan. She sought psychedelic therapy for a morale boost as well as to further
her personal growth. Susan reported that it is best to "confront your crap
rather than laying around in paradise." She found the experiences to be quite
beneficial in a number of ways. Susan found that the best experiences were
those where she had to confront her fear. She had learned that "love is not
`out there' to be found, but comes from within yourself." She has also found
herself to less defensive and judgmental, and has learned to "mind her own
business." In other words, her experiences with psychedelics have had a
positive effect on her life.

In the last decade,
research into psychedelics and entactogens has picked up pace. This is largely
attributed to the formation of the Multidisciplinary Association of Psychedelic
Studies (MAPS), who provide funding and other forms of support for studies
involving psychedelics, entactogens, and marijuana, and publish the results.
Most of the recently completed studies on the therapeutic value of psychedelics
and entactogens are followup studies, critically analyzing results from
experiments as far back as the sixties. Up until very recently there haven't
been any new experiments using a controlled substance in humans. On July 2,
2002, Dr. Francisco Moreno received final approval from the DEA to study the
effects of psilocybin, a seratonergic hallucinogen, on patients suffering from
obsessive-compulsive disorder (OCD). No results have been published yet. There
is also a study under development on the effectiveness of MDMA in treating
post-traumatic stress disorder (MAPS).

In Russia, ketamine was
evaluated for its usefulness in treating heroine addiction. Ketamine is used as
a general anesthetic, but is psychedelic at lower doses. A double-blind study
was conducted using psychedelic (for the experimental group) and
sub-psychedelic (for the control group) doses of ketamine in combination with
regular psychotherapy on a group of seventy addicts. In a six-month followup
study, it was found that 50% of the patients in the experimental group and 60%
of patients in the control group relapsed during the first three months.
However, the rate of abstinence in the first six months of the experimental
group was twice that of the control group (Burakov et al.). Further studies
would determine whether repeated sessions would further reduce the rate of
relapse.

In Switzerland,
permission was granted by the Swiss Federal Office for Public Health to a
select few psychiatrists for using LSD and MDMA in psychotherapy. This lasted
until 1993 when their permission was revoked (Gasser). A followup study was
conducted a year later by Peter Gasser, M.D. The study consisted of a questionnaire
sent to 171 patients who had undergone at least one psycholytic therapy
session. Of those, 135 responded. Two thirds (66.7%) had sought psycholytic
therapy for social problems, another 66.7% for psychological symptoms, and 57%
for self-exploration. Thirty-eight percent of the patients were diagnosed with
a personality disorder, 24.8% with an affective disorder, and 6.6% with eating
disorders. Nearly half (46.3%) reported a good improvement in their symptoms,
another 38.8% reported a slight improvement, 5.8% reported no improvement, and
4.2% reported slight deterioration (Gasser). It is also important to note that
no patients noticed an increase in use of drugs following therapy. Many
reported a decrease. All in all, the psycholytic therapy sessions with LSD and
MDMA proved to be very beneficial.

Psychedelics and
entactogens, when used in a controlled setting, are useful tools for treating
psychological disorders. They can help a patient re-experience a traumatic
event in his life and learn to cope with it, allow him to examine elements of
his character and personality which he would like to change, and have shown in
some cases to improve symptoms of psychological diseases such as obsessive
compulsive disorder and chemical dependency. Results from the studies mentioned
prove that psychedelic and psycholytic therapy are as or more effective than
psychotherapy without them for treating certain disorders. However, there is
much room for further exploration into the use of psychedelics for therapeutic
purposes.